NPIMap

Individual provider Active NPI

Fredric D Gordon, M.D.

  • Hepatology Physician
  • Boston, MA
National Provider Identifier
1891892691
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hepatology PhysicianTaxonomy code 207RI0008X
License
73902 Issued in MA
Practice address
800 Washington St BLDG 40
Boston, MA 02111-1552
Phone
(617) 636-4886
Fax
(617) 636-1003
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 73902 MA
Hepatology Physician 207RI0008X 73902 MA Primary

Addresses

Primary practice location

800 Washington St BLDG 40
Boston, MA 02111-1552

Mailing address

168 Cynthia Rd
Newton, MA 02459-2864
Phone (617) 291-3960

Other identifiers 2

IdentifierTypeStateIssuer
3133745MedicaidMA
110055325AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050707000307 MA Practitioner - Gastroenterology 7113963554 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Boston University School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pratt Surgical Associates IncGroup PAC ID 4486546082, 44 clinicians

Practice addresses (Care Compare)

800 Washington St
Boston, MA 02111-1552
Phone (617) 636-5000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Pratt Surgical Associates Inc CurrentSince Sep 1, 2022 Accepting new patients
Pratt Medical Group, Inc Gastroenterology Current Accepting new patients
Lahey Clinic, Inc. CurrentSince Dec 29, 1994 Accepting new patients
Pratt Medical Group, Inc Gastroenterology CurrentSince May 1, 2018 Accepting new patients
Lahey Clinic, Inc CurrentSince Aug 14, 2012 Accepting new patients
Pratt Medical Group, Inc CurrentSince May 1, 2018 Accepting new patients
Pratt Medical Group, Inc Past Accepting new patients

Locations

800 Washington St
Boston, MA 02111
Phone (617) 636-4800

800 Washington St
#1
Boston, MA 02111

800 Washington St
Bldg 40
Boston, MA 02111
Phone (617) 636-4886

800 Washington St
#1013
Boston, MA 02111
Phone (617) 636-0491

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

41 Mall Rd
#4W
Burlington, MA 01805
Phone (781) 744-2500

Interoperability endpoints

  • Direct secure messaging: fgordon86704@tuftsmedicine.direct-ci.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1891892691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "168 CYNTHIA RD",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024592864",
            "telephone_number": "617-291-3960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WASHINGTON ST BLDG 40",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111552",
            "telephone_number": "617-636-4886",
            "fax_number": "617-636-1003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "FREDRIC",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MA",
            "license": "73902",
            "primary": false
        },
        {
            "code": "207RI0008X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hepatology",
            "state": "MA",
            "license": "73902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3133745",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110055325A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.